Individual
JACQUELINE M KAUFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3640
(920) 433-3716
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7229
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
232951-30
WI
163WC0200X
Critical Care Medicine Registered Nurse
4704297325
MI
363L00000X
Nurse Practitioner
Primary
7839-33
WI
363LG0600X
Gerontology Nurse Practitioner
7839-33
WI
Other
Enumeration date
04/11/2017
Last updated
12/31/2019
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